Tibial plateau fracture primarily treated with knee arthroplasty - sicot

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$Percutaneous Fixation for Pipkin type II Femoral head fracture ... - sicot$

SICOT Online Report E021 Accepted February 04 th, 2003 A B Fig. 1 AP radiograph (A) and CT scan (B) showing a comminute fracture of the lateral condyle with extensions to the medial condyle She was operated upon using a total knee prosthesis - AGC (Anatomical Graduated Components, Biomet Merck). Six weeks postoperatively the patient could walk freely without a stick and had no pain. The knee was stable and had full range of movement. After one year the result was equally satisfactory. Radiographs showed no loosening of the prosthesis (Fig. 2). 2
SICOT Online Report E021 Accepted February 04 th, 2003 Fig. 2 Antero-posterior and lateral radiographs one year postoperatively. Discussion Normally this patient would have been treated with open reduction, bone transplantation and plate fixation. The knee would have been immobilized in a plaster-of-Paris for four weeks and no weight bearing allowed for 3-4 months. Being confined to a wheel chair for that long might be detrimental to an elderly person. In the long view there is a risk of developing lateral gonarthrosis necessitating total knee prosthesis [5]. So, it was reasoned, why not insert a prosthesis right away, allowing the patient immediate mobilization and weight bearing. However, no reference was found in the literature of Total Knee Replacement in the primary treatment of tibial plateau fracture. Knee arthroplasty has been used after failure of internal fixation of the tibial plateau [5]. Treatment by long 3
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Tibial plateau fracture primarily treated with knee arthroplasty - sicot

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